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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by alchemy on August 1, 2012, at 20:09:17
Many people experience a negative change when they go to a different generic. Is it ever the other way around?
Posted by Phillipa on August 1, 2012, at 23:32:43
In reply to Are generics always inferior to name brand?, posted by alchemy on August 1, 2012, at 20:09:17
some do always been very contraversial on this board. Lots in archives. Phillipa
Posted by jono_in_adelaide on August 2, 2012, at 0:29:21
In reply to Are generics always inferior to name brand?, posted by alchemy on August 1, 2012, at 20:09:17
I am convinced that this is largely mind over matter, the FDA and their equivalents in other countries requirs substantial bioavaliability testing of generics before they are allowed onto the market - you cant set your self up stamping out diazepam and sertraline tablets just because you think it would be a good money spinner.
Power of suggestion is a potent force!
Posted by Emme_V2 on August 2, 2012, at 6:14:50
In reply to Re: Are generics always inferior to name brand?, posted by jono_in_adelaide on August 2, 2012, at 0:29:21
> I am convinced that this is largely mind over matter, the FDA and their equivalents in other countries requirs substantial bioavaliability testing of generics before they are allowed onto the market - you cant set your self up stamping out diazepam and sertraline tablets just because you think it would be a good money spinner.
>
> Power of suggestion is a potent force!I disagree with you. I've had two bad experiences myself with generics despite full expectation of success (so much for mind over matter). For other drugs, generics work fine for me. For one drug, I do fine on one generic brand but poorly on another.
Generics may contain different inactive ingredients, including those for pill coatings and color or to bind the constituents into tablet form. They also may vary in the amount of drug that is available in the bloodstream. In the case of a stimulant, I found myself shaking on the generic, which never happens on the brand. The pharmacist suggested that the binding agent may have allowed more rapid release of the drug than I was used to.
I see no reason not to try a generic, but I also see no reason to discount the experiences of those who run into problems with them.
Posted by SLS on August 2, 2012, at 6:45:07
In reply to Re: Are generics always inferior to name brand?, posted by jono_in_adelaide on August 2, 2012, at 0:29:21
> I am convinced that this is largely mind over matter, the FDA and their equivalents in other countries requirs substantial bioavaliability testing of generics before they are allowed onto the market - you cant set your self up stamping out diazepam and sertraline tablets just because you think it would be a good money spinner.
>
> Power of suggestion is a potent force!It might depend on how narrow the therapeutic window is for the drug in question. For drugs like antibiotics and NSAIDs, there is very little difference in effectiveness because there is little need to be precise in dosing. The dosage range within which these drugs remain effective is virtually unlimited up until one reaches the threshold of toxicity, which is relatively high. This is not true of anticonvulsants / mood-stabilizers. The therapeutic window is relatively narrow. There is very little tolerance to differences in dosing. At too low a dosage, no efficacy exists; at too high a dosage side effects and toxicity appear. The difference in these dosages are very small; so small that the range of the deviations in bioequivalency allowed by the FDA (80-125%) is often greater than the therapeutic window of the drug. It is also important to consider that different generics are not required to be bioequivalant to each other. Switching between generics might be problematic, especially when one preparation occupies the higher end of the allowed range versus reference and the other the lower end. A 40% difference? I am not sure of my math. Interestingly, nortriptyline, a tricyclic antidepressant (TCA), has a window of efficacy for which the therapeutic effects actually disappear if one takes too much of it. No other TCA demonstrates this behavior.
Generics look good in theory and on paper. I use generics for almost every drug they were designed to replace. The one exception is Lamictal (lamotrigine), an AED. I relapsed on the two generic preparations I tried; something that I was required to do by my prescription plan. Restarting the name-brand allowed me to recapture the therapeutic effect.
http://www.ncbi.nlm.nih.gov/pubmed/18505997
http://www.ncbi.nlm.nih.gov/pubmed/17346246
There is much debate and conflicting reports to be found regarding the issue of the clinical equivalence of generic AEDs to name-brand. The two citations I included above demonstrate that this issue requires further examination.
- Scott
Posted by b2chica on August 2, 2012, at 12:40:25
In reply to Are generics always inferior to name brand?, posted by alchemy on August 1, 2012, at 20:09:17
truly depends...
i was on two generics of wellbutrin and both crappy.
take one generic of adderall Fabulous, another crappy.think it has a lot to do with body makeup and the way the med is metabolized.
Posted by bleauberry on August 2, 2012, at 17:39:08
In reply to Are generics always inferior to name brand?, posted by alchemy on August 1, 2012, at 20:09:17
> Many people experience a negative change when they go to a different generic. Is it ever the other way around?
Yes. Sometimes. My lyme doc had a generic version of one of the pain pills that he had seen outperform brand in his practice. Me, I liked nortriptyline as long as it was one particular generic brand. A different generic or brand felt bad almost like poison.
I like generic ritalin a lot better than brand.
I think the point is to try both because otherwise it is not possible to know how the patient really responded to that med.
Posted by sheilac on August 3, 2012, at 10:14:07
In reply to Re: Are generics always inferior to name brand?, posted by b2chica on August 2, 2012, at 12:40:25
Amen Emme!
The coatings and filler ingredients are very different.
Plus, one of the more popular generic makers that most of the pharmacies around here order from is Teva. I have found that their drugs either don't work at all for me (and insurance doesn't allow for name brand) or the Teva brand drugs are weaker than the originals - which means I have to take more!
Ugh! I hate generics and the fact that insurance companies want me to only buy generic or pay $400 for a name brand drug. It's ridiculous!
This is the end of the thread.
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